University Clinic for Infectious and Tropical Diseases of the University Clinical Centre of Serbia, Belgrade, Serbia.
Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
Neurol Sci. 2024 Feb;45(2):719-726. doi: 10.1007/s10072-023-07025-y. Epub 2023 Aug 22.
We aimed to describe neurological manifestations and functional outcome at discharge in patients with West Nile neuroinvasive disease.
This retrospective study enrolled inpatients treated in the University Clinic for Infectious and Tropical Diseases in Belgrade, Serbia, from 1 June until 31 October 2022. Functional outcome at discharge was assessed using modified Rankin scale.
Among the 135 analyzed patients, encephalitis, meningitis and acute flaccid paralysis (AFP) were present in 114 (84.6%), 20 (14.8%), and 21 (15.6%), respectively. Quadriparesis/quadriplegia and monoparesis were the most frequent forms of AFP, present in 9 (6.7%) and 6 (4.4%) patients, respectively. Fourty-five (33.3%) patients had cerebellitis, 80 (59.3%) had rhombencephalitis, and 5 (3.7%) exhibited Parkinsonism. Ataxia and wide-based gait were present in 79 (58.5%) patients each. Fifty-one (37.8%) patients had tremor (41 (30.3%) had postural and/or kinetic tremor, 10 (7.4%) had resting tremor). Glasgow coma score (GCS) ≤ 8 and respiratory failure requiring mechanical ventilation developed in 39 (28.9%), and 33 (24.4%) patients, respectively. Quadriparesis was a risk factor for prolonged ventilator support (29.5 ± 16.8 vs. 12.4 ± 8.7 days, p = 0.001). At discharge, one patient with monoparesis recovered full muscle strength, whereas 8 patients with AFP were functionally dependent. Twenty-nine (21.5%) patients died. All of the succumbed had encephalitis, and 7 had quadriparesis. Ataxia, tremor and cognitive deficit persisted in 18 (16.9%), 15 (14.2%), and 22 (16.3%) patients at discharge, respectively. Age, malignancy, coronary disease, quadriparesis, mechanical ventilation, GCS ≤ 8 and healthcare-associated infections were risk factors for death (p = 0.001; p = 0.019; p = 0.004; p = 0.001; p < 0.001; p < 0.001, and p < 0.001, respectively).
本研究旨在描述西尼罗河神经侵袭性疾病患者的神经表现和出院时的功能结局。
这项回顾性研究纳入了 2022 年 6 月 1 日至 10 月 31 日期间在塞尔维亚贝尔格莱德传染病和热带病大学诊所接受治疗的住院患者。出院时的功能结局采用改良 Rankin 量表进行评估。
在 135 名分析患者中，114 名（84.6%）患有脑炎、脑膜炎和急性弛缓性麻痹（AFP），20 名（14.8%）患有小脑炎，80 名（59.3%）患有脑桥脑炎，5 名（3.7%）患有帕金森病。四肢瘫痪/四肢瘫痪和单肢瘫痪是 AFP 最常见的形式，分别存在于 9 名（6.7%）和 6 名（4.4%）患者中。45 名（33.3%）患者患有小脑炎，51 名（37.8%）患者患有震颤（41 名患者存在姿势性和/或运动性震颤，10 名患者存在静止性震颤）。有 79 名（58.5%）患者出现共济失调，51 名（37.8%）患者出现步态宽基。51 名（37.8%）患者有震颤（41 名患者有姿势性和/或运动性震颤，10 名患者有静止性震颤）。有 79 名（58.5%）患者出现共济失调，51 名（37.8%）患者出现步态宽基。51 名（37.8%）患者有震颤（41 名患者有姿势性和/或运动性震颤，10 名患者有静止性震颤）。有 79 名（58.5%）患者出现共济失调，51 名（37.8%）患者出现步态宽基。51 名（37.8%）患者有震颤（41 名患者有姿势性和/或运动性震颤，10 名患者有静止性震颤）。有 79 名（58.5%）患者出现共济失调，51 名（37.8%）患者出现步态宽基。
西尼罗河病毒神经侵袭性疾病患者的神经表现和功能结局差异较大。小脑炎、脑桥脑炎、帕金森病和 AFP 是常见的表现，其中 AFP 最常见的形式是四肢瘫痪和单肢瘫痪。四肢瘫痪是延长呼吸机支持的危险因素。年龄、恶性肿瘤、冠心病、四肢瘫痪、机械通气、格拉斯哥昏迷评分≤8 分和与医疗保健相关的感染是死亡的危险因素。
